Why Awareness of Alcohol's Breast Cancer Risk Still Lags Decades Behind Tobacco

Alcohol is a well-established risk factor for several cancers, including breast cancer, yet public awareness of that connection remains strikingly low. Researchers at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) have found that only around 28% of people know that regular alcohol consumption raises the risk of at least 7 types of cancer,¹ a gap the center is now working to close specifically among young women.

Building on that finding, OSUCCC – James researchers launched a study testing whether plain-language, counter-marketing-style messages about alcohol and breast cancer risk can shift awareness and behavior. The project, which grew out of focus groups where young women helped shape the messaging using generative AI tools, is now enrolling up to 500 women ages 18 to 25 who will be randomized to receive either the newly developed alcohol-focused messages or general cancer prevention information, with daily smartphone surveys and, for some participants, wearable sensors tracking drinking. The work is part of a broader, multi-institution effort through the Big Ten Cancer Research Consortium, funded by the Breast Cancer Research Foundation.

Darren Mays, PhD, MPH, the study's lead author and a behavioral scientist at OSUCCC – James, spoke with Targeted Oncology^TM about how this research came together, what the team's focus groups revealed, and why alcohol's cancer risk has largely stayed out of the public health spotlight compared with smoking.

Targeted Oncology: How did this research develop?

Darren Mays, PhD, MPH: I'm a behavioral scientist. I focus primarily on primary cancer prevention, so healthy populations before cancer diagnoses, and in the context of that, behaviors, substance use, and other addictive behaviors with associated cancer risks. I've done a lot of work around tobacco and nicotine use and recently have been growing this work related to alcohol consumption as a cancer prevention target.

Tell us about the survey and focus group work relating to alcohol and risk of breast cancer.

This work is collaborative work through the Big Ten Cancer Research Consortium, with 5 other cancer centers in the Big Ten, funded by the Breast Cancer Research Foundation. It started with an initial study that we did focusing on young adult women 18 to 25, drawing from population data showing that most American adults are not aware that alcohol consumption can increase cancer risk. So, we collected similar data in this younger population, focused on alcohol consumption as a breast cancer risk factor and measuring their awareness, and we found that less than 30% of that young adult population recognize that drinking alcohol increases breast cancer risk.

That snowballed into work that we're doing, focused on how we can address this. Number one, what can we do to increase awareness, and can that type of intervention motivate behavior change? We started with focus groups with young women, and our interest was in how we can design communication to get this message across about drinking as a risk factor for breast cancer. We're interested in the social media space, because for a younger demographic group, that's where they get a lot of their information about health in general.

In those focus groups we did some unique things where we used generative AI to have them co-create message content with us; they told us about their ideas, and while we were conducting the focus groups, we put those ideas into a generative AI platform to show example visuals based on their ideas. We did that in an iterative way, where we generated some ideas from the first focus groups, took those, refined them a little bit based on the feedback, put them in additional focus groups to get more feedback from the target population, to land on messages that reflected the information they wanted to see, in ways that would capture their attention and resonate with them in the space of social media.

One of the things we're doing now is conducting a clinical trial² to test those messages that we created, and whether they impact young women's awareness. We're measuring alcohol consumption behavior as well, so that study is ongoing, and we'll hopefully have some findings to share from that in the next year or so.

What do you think goes behind the lack of awareness of breast cancer risk and general adverse health effects, as opposed to something like smoking?

I make a lot of comparisons with tobacco as well, because that's an area I work in too. I think at least one reason is that when we look at something like smoking, we've been studying smoking for a long time from a cancer risk perspective, and over the course of what's now been several decades, implementing policies to try to reduce smoking and engaging in mass media messaging about smoking—whether it used to be primarily PSAs on TV, radio, and that's shifted, obviously, as media have shifted.

But when you look at something like alcohol consumption from a cancer perspective, there hasn't been messaging like that. There have been things like a focus on drinking and driving, for example, and those sorts of health consequences of alcohol consumption, which are obviously important public health issues, but it's just not something that has been mainstream from a cancer risk perspective and not something where there's been that focused messaging from a public health standpoint to raise awareness and put it on people's radar as a cancer prevention issue.

From a screening perspective, does heavier drinking maybe necessitate earlier screenings, and how do you bridge that gap in communication and encourage young women to have those conversations with doctors?

I do think it's important in clinical settings for patients who are there to ask questions, because we've known for some time that physicians and other providers are viewed as trusted sources of health information. So, to get information like this to people, that's an important context for it.

The more we learn about risks—and there are all kinds of risks associated with alcohol consumption that go beyond cancer as well—it elevates the importance of screening and brief intervention in those clinical settings, whether it's primary care or in an oncology setting, where we're talking about cancer patients. It's important in both those contexts.

On the physician side of things, have you seen any gaps in knowledge or awareness of these increased risks, whether in primary care or oncology?

In the population-based survey data that we see, they have shown that for American adults in general, there's a lack of awareness, just not knowing that alcohol consumption affects cancer risk. This is a topic that's of interest to the team I'm working with too: studying this more from the clinician perspective, both from an awareness standpoint and what are the ways that we can work with them to try to address it in that setting.

REFERENCES

1. Alcohol and Cancer Risk. US Department of Health and Human Services. Accessed July 23, 2026. https://tinyurl.com/2pv7x8x5 

2. Breast Cancer Study Tracking Risk Awareness of Alcohol Consumption and Improving Knowledge in Young Adult Women (B-Track). ClinicalTrials.gov. Updated March 25, 2026. Accessed July 23, 2026. https://clinicaltrials.gov/study/NCT07320664